关键词: 肝硬化, 急性肾损伤, 血清胱抑素C, 诊断

Abstract: Objective To explorethe diagnostic efficacy of serum cystatin C on acute kidney injury （AKI） in patients with liver cirrhosis. Methods 114 patients with liver cirrhosis were recruited between January 2015 and February 2017 in our hospital,and 62 of them had AKI and 52 without. The AKI included acute tubular necrosis （ATN） in 8,hepatorenal syndrome （HRS） in 16 and prerenal azotemia （PRA） in 38. Serum albumin,total bilirubin,creatinine,urea nitrogen and cystatin C were detected,and the sensitivity,specificity and accuracy were calculated. Results 19 had coronary heart disease,17 had diabetes,and 16 had hypertension in patients with AKI,significantly higher than 12,10 and 11 in patients without（P<0.05）;serum cystatin C in patients with AKI was （2.4±0.2） mg/L,much higher than （0.9±0.1） mg/L,and serum albumin was（28.3±4.8） g/L,much lower than （34.1±7.3） g/L（P<0.05） in patients without;urea nitrogen was（15.3±5.4） mmol/L,platelet counts was （73.1±11.3）×10⁹/L,total bilirubin was（43.8±9.5） μmol/L,creatinine was（127.6±23.5） μmol/L,significantly different as compared to （6.4±3.3） mmol/L,（90.6±12.7）×10⁹/L,（23.6±6.4） μmol/L,（73.4±15.2） μmol/L in patients without AKI （P<0.05）;in the ATN group,serum cystatin C level was （3.6±1.6） mg/L,platelet counts was （102.6±21.7）× 10⁹/L, total bilirubin was （73.2±16.8）μmol/L,serum creatinine was（346.8±30.7） μmol/L,much higher than those in HRS group and in PRA group（P<0.05）;the accuracy was 92.1% and the specificity was 95.7% when serum cystatin C was used to diagnose the patients with AKI,significantly higher than those by serum creatinine or urea nitrogen（P<0.05）. Conclusion The application of serum cystatin C level in the diagnosis of liver cirrhosis patients with AKI is helpful in clinical practice,which needs further investigation.

Key words: Liver cirrhosis, Acute kidney injury, Serum Cystatin C, Diagnosis